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Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
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Approach to high intracoronary thrombus burden in the era of COVID-19

Kevin M Coy1, Andrii Maryniak2, Thomas Blankespoor3

  • 1Cardiology, University of South Dakota, Sioux Falls, South Dakota, USA coyfishcoyfish@yahoo.com.

BMJ Case Reports
|December 8, 2021
PubMed

Insights

This study details a COVID-19 patient with myocardial infarction due to coronary thrombosis. It highlights successful revascularization strategies for severe thrombus burden, including delayed intervention.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Vascular Medicine

Background:

  • The COVID-19 pandemic has been associated with various cardiovascular complications.
  • Extensive multivessel coronary thrombosis is a recognized, albeit uncommon, manifestation of SARS-CoV-2 infection.

Observation:

  • This case report focuses on a patient hospitalized with acute hypoxic respiratory failure due to COVID-19.
  • The patient subsequently developed non-ST elevation myocardial infarction, indicating a serious cardiac event during their illness.

Findings:

  • The study reviews immediate and delayed revascularization strategies for coronary lesions in the context of SARS-CoV-2-induced high intracoronary thrombus burden.
  • Successful percutaneous intervention and stenting of the primary culprit lesion were achieved.
  • A delayed strategy involving lesion passivation with adjuvant pharmacotherapy led to the resolution of intracoronary thrombus, confirmed by follow-up angiography.

Implications:

  • This case demonstrates the feasibility and effectiveness of tailored revascularization approaches in managing complex coronary thrombosis associated with COVID-19.
  • The findings underscore the importance of considering cardiovascular manifestations in COVID-19 patients and highlight the role of both immediate and delayed interventional strategies.
  • Effective management of SARS-CoV-2-related coronary thrombosis can improve patient outcomes.

Keywords:
COVID-19cardiovascular medicineheart failureinterventional cardiologyischaemic heart disease

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